Michael Walker and Dr. Katherine Fordham

January 1997

Life, Love and AIDS

Welcome to the second edition of our column for Oasis. Let us
say (once again) that we are so excited to be here; Oasis is
providing an excellent forum for the open communication of issues
affecting queer youth and the two of us are proud to be part such
a noble effort.

Now on to the health issues, which, of course, is what we are
here for in the first place. Since the first edition of our
column was just published, and Oasis contributors are required to
turn in their column material way ahead of publication time (a
common and needed requirement of most periodicals); we won't be
addressing any questions which you guys may have sent our way
after the tenth of December in this issue. We did get a question
from a reader early into the month, and that's going to be topic
of the entire column this month. In the meantime, keep the
questions coming!

Dear Mike and Dr. Kate:

I was reading your column and wondered about something: is
anal sex safe? I don't mean about getting AIDS -that kind of
safe- but I heard somewhere that you can get hurt somehow if
you do it and that's why it's illegal in some places. Is that
true?

Brad D.

Dear Brad:

Thanks for bringing up an important and seldom-addressed
subject. Anal sex has long been a very controversial issue in the
medical, religious, and social communities. Obviously, it is
something which many people feel uncomfortable talking about but
nonetheless, it is something which sexually-active gay men should
be informed about so they can make intelligent decisions on this
subject.

The anus is intended to function primarily as a means of
eliminating waste from the body. It is attached to the rectum,
which is the final section of the gastrointestinal tract. In the
male body, the rectum and anal canal are located behind the
bladder and prostate gland; the anal canal itself is only about
an inch in length. The reason that anal sex is enjoyable is
because the tissue of the anus is very sensitive, in much the
same way that the skin of the sex organs is, and is thus
stimulated in a similar manner. Also, anal sex can stimulate the
prostate gland itself; thus the prostate has been often described
as "the male G-spot". The opening which allows waste to
pass out of the body through the anus is known as the external
anal sphincter. This is also the point where something can enter
the anus, in a sexual context, and much of the danger surrounding
anal sex is that since the sphincter is designed to pass things
outside the body, and not to act as an orifice into the body;
anything that forces the sphincter to open from the outside may
put strain on it. Therefore, nothing too large should be inserted
into the anus. (Many of you reading this may be rolling on the
floor with laughter right now; but this is an important point.)
Certainly nothing that is artificial, like any sort of man-made
object should ever be inserted into the anus, except in some
medical procedures. Anything that is too large, or extremely
hard, or sharp, can tear the soft interior tissue of the anal
canal. Lubrication is essential in anal intercourse; but it is
important not to use a lubrication which is oil-based as many
such substances can react against latex condoms and leave small
holes in them which might allow fluids to be exchanged between
the two people engaging in sex: exactly what you are trying to
avoid by wearing a condom in the first place!

Tearing of the tissue within the anal canal can cause bleeding
and thus encourage the transmission of sexually transmitted
diseases. In extreme cases, objects inserted in the anus which
are very large or are inserted with severe force can lead to
serious medical problems, such as damage to the external anal
sphincter and other, similar, sphincters further up the rectal
route. Also, the organs near the anal canal can be damaged
through anal intercourse if the sexual act is unusually forceful
and aggressive. Most cases of anal canal and rectal damage seen
by physicians are the result of either rape, where sex is
forceful and violent, or in cases of child sexual abuse where the
anal canal is smaller and not fully developed, therefore more
susceptible to trauma. Since this column is targeted primarily
towards adolescents, we wish to stress that the younger you are,
the greater the potential for injury during anal intercourse due
to the smaller size of the anus and associated organs.

Another important risk factor of anal sex is that small items
which are forced into the anus can get trapped in the anal canal.
There have been documented cases where doctors have seen such
items become lodged in the canal, including condoms which were
not properly used. It is essential that a condom is worn during
anal intercourse because the risk of transmission of AIDS and
other STDs during anal sex is very high. But is also imperative
that the condom is properly worn and that care is taken so that
the condom will not come off inside the anal canal (which it
should not providing that condom is being used correctly). Always
pay attention to the instructions which come with condoms!

Both of us are what you can consider realists: that is, we
face issues -especially sex-related issues- in a logical and
realistic way. We know that some of our readers probably engage
in anal intercourse and others may be considering it, and
therefore feel it is our obligation to provide information on the
subject. We are not going to take a moralist view on this nor
condemn it outright. But please understand that while anal sex
may be enjoyable, as we stated before, intercourse is not the
primary function of the anus and there are dangers involved; the
risk of contracting a communicable disease like AIDS and also the
risk of physical damage due to the sex act itself. If you are
young, the risks are greater. Also, there are psychological,
emotional, and legal aspects to consider. Some people enjoy anal
sex, but some others don't. Like any form of sex, you should only
participate in it if you are one hundred percent sure that you
feel comfortable engaging in such activity. Anal sex, or sodomy,
is illegal in a fair number of states, as well. The reason it is
illegal has much more to do with religious concepts than medical
concerns. No matter what your personal opinion of such laws may
be; keep in mind that laws are laws all the same, and there could
be legal consequences for your behavior, although the sodomy laws
are rarely enforced unless rape or abuse is a factor.

In closing, remember that it is your body which we are talking
about and while what you do with your body is entirely your
business; it is something which you should take very seriously
and always consider the possible ramifications when engaging in
any sexual practices. Until next month, stay safe!